Oxford Guide to Low Intensity CBT Interventions

2015 ◽  
Keyword(s):  
Mental Health Problems ◽  
Therapy Group ◽  
Cost Effective ◽  
Individual Therapy ◽  
Behaviour Therapy ◽  
Low Intensity ◽  
Self Help ◽  
Cognitive Behaviour ◽  
Bulletin Boards ◽  
The Many

This Guide documents the drive to democratise psychotherapy. Its 62 chapters by world leaders in the field detail how to help the many, not just a privileged few. They draw together a wealth of evidence on ways to give short cost-effective therapy and prevent mental health problems, especially depression and anxiety. The result is a rich work of reference. It includes historical, organisational and training aspects, assessment, monitoring, homework and evaluation, self-help by books and by computer, and government initiatives to broaden access to help. The Guide focuses on short forms of cognitive behaviour therapy (CBT). It depicts progress in the broadening of access, but adds a caveat. For one reason or another, a huge proportion of sufferers do not use readily available health services. Using examples of the STEPS program to explore imaginative efforts to reach such people in deprived multi-ethnic areas in Glasgow via brief-advice clinics, education classes with over 100 attendees, and links to employment, financial and interest groups, and other community facilities. Additionally, the Australian ‘beyondblue’ website initiative outlines impressive ways to increase community awareness of depression and its low intensity. The volume covers further refreshingly diverse means of delivering care. They include brief face-to-face individual therapy, group work, contact by phone, email, SMS, and bulletin boards, as well as self-help books and computer-aided programs. The aim is to ‘get more bang for our buck’ - to help as many sufferers as possible in the minimum time needed from practitioners who are trained to provide low intensity services and measure outcome.

scholarly journals Self-guided mindfulness and cognitive behavioural practices reduce anxiety in autistic adults: A pilot 8-month waitlist-controlled trial of widely available online tools

Autism ◽  
2020 ◽  
Vol 24 (4) ◽  
pp. 867-883 ◽  
Author(s):  
Sebastian B Gaigg ◽  
Paul E Flaxman ◽  
Gracie McLaven ◽  
Ritika Shah ◽  
Dermot M Bowler ◽  
...  
Keyword(s):  
Mental Health ◽  
Cognitive Behaviour Therapy ◽  
Controlled Trial ◽  
Cost Effective ◽  
Well Being ◽  
Behaviour Therapy ◽  
Self Help ◽  
Online Tools ◽  
Cognitive Behaviour ◽  
Autistic Adults

Anxiety in autism is an important treatment target because of its consequences for quality of life and well-being. Growing evidence suggests that cognitive behaviour therapies and mindfulness-based therapies can ameliorate anxiety in autism but cost-effective delivery remains a challenge. This pilot randomised controlled trial examined whether online cognitive behaviour therapy and mindfulness-based therapy self-help programmes could help reduce anxiety in 54 autistic adults who were randomly allocated to either an online cognitive behaviour therapy (n = 16) or mindfulness-based therapy (n = 19) programme or a waitlist control group (n = 19). Primary outcome measures of anxiety, secondary outcome measures of broader well-being and potential process of change variables were collected at baseline, after programme completion, and then 3 and 6 months post-completion. Baseline data confirmed that intolerance of uncertainty and emotional acceptance accounted for up to 61% of self-reported anxiety across all participants. The 23 participants who were retained in the active conditions (14 mindfulness-based therapies, 9 cognitive behaviour therapies) showed significant decreases in anxiety that were maintained over 3, and to some extent also 6 months. Overall, results suggest that online self-help cognitive behaviour therapy and mindfulness-based therapy tools may provide a cost-effective method for delivering mental health support to those autistic adults who can engage effectively with online support tools. Lay abstract Anxiety in autism is an important target for psychological therapies because it is very common and because it significantly impacts upon quality of life and well-being. Growing evidence suggests that cognitive behaviour therapies and mindfulness-based therapies can help autistic individuals learn to manage feelings of anxiety but access to such therapies remains problematic. In the current pilot study, we examined whether existing online cognitive behaviour therapy and mindfulness-based therapy self-help tools can help reduce anxiety in autistic adults. Specifically, 35 autistic adults were asked to try either an existing online cognitive behaviour therapy (n = 16) or mindfulness-based therapy (n = 19) programme while a further 19 autistic adults served as a waitlist comparison group. A first important finding was that 23 of the 35 (66%) participants who tried the online tools completed them, suggesting that such tools are, in principle, acceptable to many autistic adults. In addition, adults in the cognitive behaviour therapy and mindfulness-based therapy conditions reported significant decreases in anxiety over 3 and to some extent also 6 months that were less apparent in the waitlist group of participants. On broader measures of mental health and well-being, the benefits of the online tools were less apparent. Overall, the results suggest that online self-help cognitive behaviour therapy and mindfulness-based therapy tools should be explored further as a means of providing cost-effective mental health support to at least those autistic individuals who can engage effectively with such online tools.

A UNITED KINGDOM SURVEY OF ACCRED ITED COGNITIVE BEHAVIOUR THERAPISTS' ATTITUDES TOWARDS AND USE OF STRUCTURED SELF-HELP MATERIALS

2002 ◽  
Vol 30 (2) ◽  
pp. 193-203 ◽  
Author(s):  
Helen Keeley ◽  
Chris Williams ◽  
David A. Shapiro
Keyword(s):  
United Kingdom ◽  
Individual Therapy ◽  
Health Care Practitioner ◽  
Behaviour Therapy ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The United Kingdom ◽  
Self Help ◽  
Cognitive Behaviour ◽  
Materials Used

Self-help materials can be offered to clients/patients either for use alone (unsupported self-help) or to support work with a health care practitioner (supported self-help). Structured self-help materials that use a Cognitive Behaviour Therapy (CBT) treatment approach have been shown to be clinically effective. We report a national survey of all 500 cognitive and behavioural psychotherapists registered with the British Association for Behavioural and Cognitive Psychotherapies, the lead organisation for CBT in the United Kingdom. A total of 265 therapists responded (53%). Self-help materials were used by 88.7% of therapists and were mostly provided as a supplement to individual therapy. Self-help was most frequently used to help patients experiencing depression, anxiety and obsessive compulsive disorder and was largely delivered using paper-based formats. The majority of self-help materials used a CBT approach. Only 36.2% of therapists had been trained in how to use self-help treatments, and those who had received training recommended self-help treatments to more clients/patients per week and rated self-help approaches as being significantly more helpful than those who had not received training.

Increasing Access to CBT: Stepped Care and CBT Self-Help Models in Practice

2008 ◽  
Vol 36 (6) ◽  
pp. 675-683 ◽  
Author(s):  
Chris Williams ◽  
Rebeca Martinez
Keyword(s):  
High Intensity ◽  
Phase 1 ◽  
Stepped Care ◽  
Service Development ◽  
Second Phase ◽  
Behaviour Therapy ◽  
New Ways Of Working ◽  
Low Intensity ◽  
Self Help ◽  
Cognitive Behaviour

AbstractThe delivery of cognitive behaviour therapy (CBT) in the UK has moved through two phases. In the first phase specialist practitioners delivered bespoke CBT to individuals often experiencing complex and longer-lasting problems. This phase has been characterized by waiting lists and a high quality service delivered to a few. In the second phase of service delivery CBT has begun to be delivered in all sorts of different formats, including CBT self-help/guided CBT, behavioural activation, computerized CBT and group based CBT that aim to increase access to CBT delivered in these ways. It remains unclear how these varying models – “high intensity” (phase 1) and “low intensity” (phase 2) should relate – and even who does best with each. There are implicit assumptions by practitioners reflected in language such as “stepping up/down” that assumes high intensity working is superior in some way to low intensity. Few studies have however examined this in depth and what studies there are suggest these beliefs may be incorrect for many. How these new ways of working will be introduced, evaluated and integrated into existing services currently remains a challenge. A helpful way of resolving some of these issues is to view CBT using a learning/teaching paradigm. In this the focus is primarily on how the client wishes to learn to tackle their problems. This provides a helpful way for both introducing different and new ways of working, and also maintaining a focus on the client's needs at the centre of service development. Crucially, phase two CBT working does not replace phase one. How the two approaches complement each other and compare will be two of the interesting questions to be addressed over the next few years.

scholarly journals The feasibility of low-intensity psychological therapy for depression co-occurring with autism in adults: The Autism Depression Trial (ADEPT) – a pilot randomised controlled trial

Autism ◽  
2019 ◽  
Vol 24 (6) ◽  
pp. 1360-1372 ◽  
Author(s):  
Ailsa Russell ◽  
Daisy M Gaunt ◽  
Kate Cooper ◽  
Stephen Barton ◽  
Jeremy Horwood ◽  
...  
Keyword(s):  
Randomised Controlled Trial ◽  
Cognitive Behaviour Therapy ◽  
Controlled Trial ◽  
Behaviour Therapy ◽  
Treatment As Usual ◽  
Pilot Randomised Controlled Trial ◽  
Low Intensity ◽  
Self Help ◽  
Cognitive Behaviour ◽  
Randomised Controlled

Low-intensity cognitive behaviour therapy including behavioural activation is an evidence-based treatment for depression, a condition frequently co-occurring with autism. The feasibility of adapting low-intensity cognitive behaviour therapy for depression to meet the needs of autistic adults via a randomised controlled trial was investigated. The adapted intervention (guided self-help) comprised materials for nine individual sessions with a low-intensity psychological therapist. Autistic adults (n = 70) with depression (Patient Health Questionnaire-9 score ⩾10) recruited from National Health Service adult autism services and research cohorts were randomly allocated to guided self-help or treatment as usual. Outcomes at 10-, 16- and 24-weeks post-randomisation were blind to treatment group. Rates of retention in the study differed by treatment group with more participants attending follow-up in the guided self-help group than treatment as usual. The adapted intervention was well-received, 86% (n = 30/35) of participants attended the pre-defined ‘dose’ of five sessions of treatment and 71% (25/35) attended all treatment sessions. The findings of this pilot randomised controlled trial indicate that low-intensity cognitive behaviour therapy informed by behavioural activation can be successfully adapted to meet the needs of autistic people. Evaluation of the effectiveness of this intervention in a full scale randomised controlled trial is now warranted.

scholarly journals Understanding Black and Minority Ethnic service user's experience of racism as part of the assessment, formulation and treatment of mental health problems in cognitive behaviour therapy

2019 ◽  
Vol 12 ◽  
Author(s):  
Andrew Beck
Keyword(s):  
Mental Health ◽  
Cognitive Behaviour Therapy ◽  
Mental Health Problems ◽  
Cumulative Risk ◽  
Health Problems ◽  
Service Users ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Engagement Process ◽  
Minority Ethnic

AbstractExperiences of racism can be a cumulative risk factor for developing mental health problems. Cognitive Behaviour Therapists working with Black and Minority Ethnic (BME) service users should be confident in their ability to establish the necessary rapport to ask about these experiences and be able to incorporate this information into longitudinal formulations and as part of maintenance cycles. This paper sets out guidelines as to how to do this as part of a wider engagement process.

scholarly journals Improving self-efficacy with cognitive restructuring and self instruction: An experimental study in senior high school

2021 ◽  
Vol 8 (1) ◽  
pp. 09-14
Author(s):  
Thisadewi Anggita ◽  
Sugiyo Sugiyo ◽  
Awalya Awalya
Keyword(s):  
Self Efficacy ◽  
Therapy Group ◽  
Cognitive Restructuring ◽  
Group Counselling ◽  
Behaviour Therapy ◽  
Counselling Services ◽  
Psychological Scale ◽  
Analysis Technique ◽  
Cognitive Behaviour ◽  
Self Instruction

This study aims to analyze the effectiveness of cognitive behaviour therapy group counselling with cognitive restructuring techniques and effective self-instruction techniques to increase the self-efficacy of MA Al-Manar students. The population in this study were 136 students of MA AL Manar Semarang Regency, with a sample of 24 people consisting of 8 groups with cognitive restructuring techniques, 8 groups of self-instruction techniques, and 8 groups with cognitive restructuring techniques and self-instruction. . Data collection techniques using a psychological scale. The data analysis technique used Paired Sample t-Test and One-Way Anova test. The results showed that the intervention carried out with cognitive restructuring technique group counselling and self-instruction was effective to increase self-efficacy. These results imply the importance of guidance and counselling teachers to continue to develop the use of guidance and counselling services in dealing with student self-efficacy problems.

scholarly journals @Home eTherapy Service for People with Common Mental Health Problems: an Evaluation

2017 ◽  
Vol 46 (1) ◽  
pp. 115-120 ◽  
Author(s):  
Judith Gellatly ◽  
Leanne Chisnall ◽  
Nic Seccombe ◽  
Kathryn Ragan ◽  
Nicola Lidbetter ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Problems ◽  
Treatment Options ◽  
Third Sector ◽  
Health Problems ◽  
Initial Assessment ◽  
Successful Implementation ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Common Mental Health Problems

Background: Ensuring rapid access to psychological interventions is a priority of mental health services. The involvement of peer workers to support the delivery of more accessible treatment options such as computerized cognitive behaviour therapy (CCBT) is recognized. Aims: To evaluate the implementation of a third sector remote CCBT @Home eTherapy service for people experiencing common mental health problems supported by individuals with lived experience. Method: Supported CCBT packages with telephone support were delivered over a 30-month period. Self-complete measures identifying levels of depression, anxiety and functioning were administered at each treatment appointment. Results: Over 2000 people were referred to the @Home eTherapy service; two-thirds attended an initial assessment and 53.4% of referrals assigned to CCBT completed treatment. Statistically significant improvements in anxiety, depression and functioning were found, with 61.6% of treated clients meeting recovery criteria. Conclusions: The service meets Improving Access to Psychological Therapies (IAPT) key performance targets, and is comparable to other IAPT services using CCBT. Evidence for the successful implementation of such a service by a third sector organization is provided.

scholarly journals Patient experience of Guided self-help CBT intervention for VoicEs (GiVE) delivered within a pilot randomized controlled trial

2020 ◽  
Vol 13 ◽  
Author(s):  
Cassie M. Hazell ◽  
Orla Kelly ◽  
Sorcha O’Brien ◽  
Clara Strauss ◽  
Kate Cavanagh ◽  
...  
Keyword(s):  
Patient Experience ◽  
Controlled Trial ◽  
Pilot Trial ◽  
List Type ◽  
Behaviour Therapy ◽  
Hearing Voices ◽  
Self Help ◽  
Cognitive Behaviour ◽  
Therapy Sessions ◽  
Trial Participants

Abstract Access to cognitive behaviour therapy for those with psychosis (CBTp) remains poor. The most frequently endorsed barrier to implementation is a lack of resources. To improve access to CBTp, we developed a brief form of CBTp that specifically targets voice-related distress. The results of our pilot trial of guided self-help CBT for voices (GiVE) suggest that the therapy is both acceptable and beneficial. The present study aims to explore the subjective patient experience of accessing GiVE in the context of a trial. We interviewed nine trial participants using the Change Interview and a mixed methods approach. Most participants reported at least one positive change that they attributed to GiVE. We extracted five themes: (1) changes that I have noticed; (2) I am not alone; (3) positive therapy experiences; (4) I want more therapy; and (5) helping myself. The themes indicate that participating in the GiVE trial was generally a positive experience. The main areas in which participants experienced changes were improved self-esteem, and the ability to cope with voices. Positive changes were facilitated by embracing and enacting ‘self-help’ and having support both in and out of the therapy sessions. The findings support the use of self-help materials with those distressed by hearing voices, but that support both within and outside the clinical setting can aid engagement and outcomes. Overall, the findings support the continued investigation of GiVE. Key learning aims (1) To explore participants’ experience of accessing GiVE as part of a trial. (2) To identify what (if any) changes participants noticed over the course of the GiVE trial. (3) To identify what participants attribute these changes to.

Group therapists: combine alliance building with paying specific attention to the patient’s perception

2020 ◽  
Vol 13 ◽  
Author(s):  
Beate Muschalla
Keyword(s):  
Group Process ◽  
Therapy Group ◽  
Group Session ◽  
List Type ◽  
Behaviour Therapy ◽  
Technical Performance ◽  
Cognitive Behaviour ◽  
Group Sessions ◽  
Patient’S Perception ◽  
Alliance Building

Abstract In slow-open groups as well as therapies of less than ten sessions, each group session holds importance. Patients, therapists and co-therapists have different perspectives and may gain different experiences from a group session. This study investigates the perspectives of patients, therapists and co-therapists on alliance, new insights and therapist techniques in the same group session. Do the three actors perceive these group aspects similarly or differently? Which group aspects are related with the outcome coping? One hundred and forty-nine sessions of a cognitive behaviour therapy group have been investigated. Patients, therapists and co-therapists gave ratings on their perceived alliance, group topics and insights as well as therapists’ technique competency. Concerning new insights, there was concordance between patients and co-therapists (r = .211, p < .05). Concerning alliance, there was a concordance between patients and therapists (r = .327, p < .01). Therapists focusing on alliance building was associated with lower patient outcomes in terms of work coping (β = –.391). The quality of therapeutic techniques was the same in groups with higher and lower outcomes. Patients’ perception of whether they felt good in the group session was explanative for session outcome, while therapists’ perceptions and context conditions (supervision, number of participants) was not. Patients, therapists and co-therapists have different perspectives on the same group therapy session. Patients’ perceptions are associated with session outcomes. A lower session outcome must not be associated with a poor technique performance of the therapist. Therapists should not only be aware of alliance building and correct technical performance, but they must also be aware of patients’ perceptions of the group process and outcome. Key learning aims The present research is the first evaluation of group session aspects and session outcomes in rehabilitation patients with work anxieties in slow-open groups. We will learn: (1) Whether patients’, therapists’ and co-therapists’ perceptions of the same group session are similar or different; (2) Whether group sessions that result in worse outcomes are different from group sessions resulting in a better outcome; (3) Which aspects of the group session are predictive for a better outcome.

The Treatment of Bulimia Nervosa

1987 ◽  
Vol 21 (1) ◽  
pp. 5-15 ◽  
Author(s):  
Rosalyn A. Griffiths ◽  
Stephen W. Touyz ◽  
Philip B. Mitchell ◽  
Wendy Bacon
Keyword(s):  
Family Therapy ◽  
Treatment Group ◽  
Bulimia Nervosa ◽  
Support Groups ◽  
Cognitive Behaviour Therapy ◽  
Psychoanalytic Psychotherapy ◽  
Future Research ◽  
Behaviour Therapy ◽  
Self Help ◽  
Cognitive Behaviour

We review treatment approaches to bulimia nervosa, with particular emphasis on methodology and research design. The following treatments are considered: behaviour therapy, cognitive behaviour therapy, pharmacological treatment, group therapy, psychoanalytic psychotherapy, self-help and support groups, hypnosis and miscellaneous (family therapy and nutritional approaches). Several directions for future research and methodological recommendations are suggested.

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